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Background: Cytokine plays a pivotal role in the pathogenesis of coronavirus disease 2019 (COVID-19). Cytokine storm is characterized by rapid elevation of an inflammatory circulating cytokine such as interleukin-6 (IL-6) and IL-1. However, according to evidence, genetic variables may affect the development and course of infectious diseases. Multiple genetic polymorphisms, mostly single-nucleotide polymorphisms (SNPs), have been linked to this setting's predisposition to viral infections. This study aimed to determine the frequency distribution of IL-6 SNPs rs1800795 and IL-1β SNPs rs16944 and rs1143627 gene polymorphisms and their association with the clinical severity of COVID-19 patients in Surakarta, Indonesia. This study aims to determine the association between IL-6 rs1800795 and IL-1β rs16944 with COVID-19 clinical severity. Methods: This study used a cross sectional design conducted at Universitas Sebelas Maret Hospital and centralized isolation of the Donohudan Hajj Dormitory from May to November 2021. A total of 120 COVID-19 patients were divided into 3 groups: asymptomatic, mild-moderate, and severe-critical. The detection of IL-6 SNPs rs1800795 and IL-1β SNPs rs16944 was carried out by quantitative PCR (qPCR) examination, and IL-6 and IL-1β were determined by the ELISA method. Result: There was no significant association between IL-6 SNPs rs1800795 (p=1.000) and IL-1β SNPs rs16944 (p=0.119) with clinical severity. In IL-1β SNPs rs16944 gene polymorphisms, the GG genotype was more commonly found in the asymptomatic group. AG genotype was commonly found in the symptomatic group (mild to critical). There was a significant association between IL-1β levels and clinical severity (p=0.03), whereas the association between IL-6 levels and clinical severity is not significant (p=0.103). Conclusion: There was a correlation between IL-1β levels with clinical severity. In IL-1β SNPs rs16944, the GG genotype may act as a protective factor, whereas the AG genotype may act as a factor that increases the clinical severity of COVID-19. © 2023, Sanglah General Hospital. All rights reserved.
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Background: Coronavirus disease 2019 (COVID-19) has emerged as a global health catastrophe since its first reported cases in late December 2019. Critically ill COVID-19 patients have been related to cytokine storms leading to acute respiratory distress syndrome and high mortality rates. Therapeutic plasma exchange (TPE) and convalescent plasma (CP) therapy improve clinically by removing inflammatory cytokines excess and using passive antibody-containing blood, respectively. This study aimed to evaluate TPE and CP treatment for moderate-to-severe COVID-19 infection.Method: The patients were randomly divided into TPE group (n = 10), CP group (n = 11), and control group (n = 10). This 1-week quasi-experimental study with a pretest-post-test control group design was conducted in the Intensive Care Unit (ICU) of Dr. Moewardi General Hospital and Universitas Sebelas Maret (UNS) Hospital. The study comparison between groups included blood gas analysis profile (pH, base excess, PaCO2, PaO2, hematocrit, HCO3, total CO2, SaO2), FiO2, P/F ratio, COVID-19 severity, and D-dimer. The paired t-test was used to analyze every group's pretest-post-test mean difference. One-way ANOVA was performed to analyze the mean difference across the three groups. SPSS version 22.0 for Windows was used to perform statistical analyses.Result: TPE and CP groups showed significant clinical-laboratory improvement than control (p > 0.05). Furthermore, high clinical-laboratory improvement tendency was observed in CP therapy than TPE.Conclusion: The use of TPE and CP in moderate-to-severe COVID-19 patients has been related to improving clinical -laboratory outcomes.
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Introduction: To date, no specific therapeutic drug has been approved to target SARS-CoV-2. Hence, it remains a major challenge to decide what potential therapeutic regimens to treat COVID-19 patients. This study aims to investigate curcumin and virgin coconut oil (VCO) effects on cytokine levels (IL-1β, IL-2, IL-6, IL-18, TNF-α, and IFN-β) in COVID-19 patients. Methods: This study was a single-center, controlled trial with a parallel Arm or a Randomized Clinical trial design. A total of sixty COVID-19 patients admitted to the Universitas Sebelas Maret Hospital, Surakarta, Indonesia, were divided into two groups. The first group, consisting of 30 patients, was treated with Azithromycin 500 mg + Oseltamivir 2×75 mg + Hydroxychloroquine 400 mg/day for 5 days. The second group, comprising 30 patients, was treated with Azithromycin 500 mg + Oseltamivir 2×75 mg + Hydroxychloroquine 400 mg/day for 5 days, added with VCO 30 mL and curcumin 3×1 g/day for 21 days. The cytokine profiles of the serum samples were analyzed by the enzyme-linked immunosorbent assay (ELISA) on days 1, 14, and 21. Results: Our study showed that the second group had a significant reduction in IL-1β, IL-2, IL-6, TNF-α, and IFN-β levels after being treated with standard therapy added with curcumin and VCO on day 21 (p<0.05). Conclusion: These results su ested that curcumin and VCO mi ht benefit the treatment of COVID-19 atients
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COVID-19 has been a global problem that affects various aspects of life. Hospital management is mostly affected by the COVID-19 pandemic.The COVID-19 pandemiccauses patients to be reluctant to go to the hospital. Universitas Sebelas Maret (UNS) Hospital, Indonesia has been trying to increase patient trust in the hospital and maintain the quality of service. This case study aims to report the efforts made by UNS Hospital to maintain numbers of hospital outpatient visits during the COVID-19 pandemic. The aim of this case study is to determine the number of outpatient visits at UNS Hospital in 2020 and the patients’ satisfaction rate. The number of outpatient visits of the UNS hospital decreased during this pandemic. The satisfaction survey shows that the patients feel very satisfied about the quality of services at UNS Hospital. COVID-19 does affect the outpatient clinic services. UNS hospital has to be able to develop innovations and improve the quality of services in order to survive during this pandemic. © 2022 UPM Press. All rights reserved.
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Introduction: Stress has been reported in patients with COVID-19. The current study aims to determine the effect of psychoeducation and relaxation psychotherapy on the stress and adrenaline levels of COVID-19 patients at the Sebelas Maret University (UNS) Hospital. Methods: A quasi-experimental study with the criteria of moderate COVID-19 patients,willing to take part in the study were selected. The research subjects consisted of 28 individuals divided into two groups, the treatment group and the control group. The stress level in COVID-19 patients was measured using the Perceived Stress Scale (PSS), while the adrenaline level was measured using the ELISA. The statistical test used the paired t-test or Wilcoxon test and independent t-test or Mann Whitney test. Results: The study shows a significant decrease in PSS of the treatment groups (11.36±5.65 to 7.93±4.75;p=0.012). There was a decrease in PSS of the control group, but it was not statistically significant (12.85±4.69 to 11.15±4.68;p=0.085). The adrenaline levels increased in both the treatment and control groups, but they were not statistically significant. The adrenaline levels of the control group were 8.28±5.18 pg/mL to 8.75±4.87 pg/mL (p=0.794) and 9.87±5.87 pg/mL to 9.92±4.77 pg/ mL (p=0.986) in the treatment group. Conclusion: The current study shows that combination psychoeducation and relaxation decrease the stress levels (PSS score) of COVID-19 patients at the UNS Hospital. © 2022 UPM Press. All rights reserved.
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Introduction: Frontline health workers dealing with the coronavirus disease-2019 (COVID-19) pandemic face numerous mental health problems ranging from extreme pressure and apprehension to severe depression. It has been reported that 2003 SARS pandemic had psychological impact on health care workers. The aim of this study is to investigate the depression, anxiety, and stress level among nurses at Universitas Sebelas Maret (UNS) Hospital post one year of COVID-19 pandemic. Methods: This is a cross sectional study that was conducted using the Google-form based DASS-42 questionnaire. The subjects were nurses in the COVID-19 and non-COVID-19 wardrooms. Results: : The average age of the subjects was 25.59+2.64 for the COVID-19 nurses and 27.58+3.38 for the non-COVID-19 nurses. The maximum scores obtained were 16 which is classified as moderate depression, 20 which is classified as very severe anxiety, and 16 which is classified as moderate stress level. The scores for depression, anxiety, and stress levels were 4.24+3.94;3.06+3.57;and 4.27+4.52, respectively, while the nurses in the COVID-19 ward were 5.32+5.47;5+5.93;and 5.85+6.18. Statistical analysis revealed that there was no difference of depression with a p value of 0.35, anxiety with a p value of 0.087, and stress levels with a p value of 0.224, between nurses in COVID-19 wards and non-COVID-19 wards. Conclusion: The depression, anxiety, and stress level are not statistically different between the two groups. © 2022 UPM Press. All rights reserved.
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Coronavirus disease 2019 (COVID-19) is closely related to Systemic Lupus Erythematosus (SLE). COVID-19 can cause SLE with the formation of autoantibodies. SLE patients have dysregulation and weakness in the immune system, so they are vulnerable to COVID-19 infection. A 29-year-old man came to the Emergency Unit with fever and weakness complaints. Follow-up examination revealed thrombocytopenia, increased neutrophil to lymphocyte ratio, and elevated hsCRP. A chest X-ray showed pneumonia, PCR examination showed a positive result for the SARS-CoV-2 virus, the ANA IF level was 1/320, and the ANA profile test was positive for PCNA antibodies. Diagnosis and treatment of SLE patients with COVID-19 coinfection become problematic because COVID-19 is a hyperinflammatory disease like SLE. Immunosuppressant drugs in SLE will cause weakness of the immune system and broader spread of the virus, so it needs strict evaluation and proper timing of drug administration. © 2022 UPM Press. All rights reserved.
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Introduction: COVID-19 has been a global problem and many aspects related to the mechanism of COVID-19 in damaging patients’ organs have not been known. Interleukin 6 is a severity marker of the cytokine storm in COVID-19. This study aimed to determine the relationship between interleukin 6 with cortisol and adrenaline in COVID-19 patients. Methods: Employing a cross-sectional design, the study was conducted at UNS (Sebelas Maret University) hospital from May to September 2020. Examination of interleukin 6, adrenaline and cortisol by taking the patients’ blood sample was conducted at 8 AM on the first and seventh day of hospitalization. Statistical test was performed using Pearson correlation. P is significant if it is less than 0.05. Results: This study shows that in COVID-19 patients, there is adrenal insufficiency with an average cortisol level of 0.91+0.53 ng/mL and an average adrenaline level of 9.20+4.29 pg/mL. The mean interleukin 6 in this study is 8.31+13.7 pg / mL. Interleukin 6 will increase the secretion of the hormone cortisol (p = 0.01;r = 0.575) and is not related to adrenaline (p = 0.057;r = 0.771). Conclusion: The COVID-19 patients experienced adrenal insufficiency, and Interleukin 6 associated with an increased cortisol hormone. The use of steroids may be beneficial in COVID-19 patients with adrenal insufficiency. © 2022 UPM Press. All rights reserved.
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Background: In the current COVID-19 pandemic, the number of hospital visits was significantly decreased. There was a decrease in the number of outpatient visits from 9911 patients in January to 5586 patients in May 2020 in UNS hospital. This study aims to know the association the level of stress, hospital service quality, and fear of COVID 19 with hospital visits at UNS Hospital. Research methods: The study was conducted at UNS Hospital in July 2020 using the questionnaire method. Research tools with hospital service quality questionnaire, stress level questionnaire, fear for COVID-19 scale. The patient group was divided into two, the on-time outpatient group, which always met the schedule visit doctor, and the loss of follow-up outpatient, which was a late schedule to the hospital. Statistical test using t-test and Mann Whitney test, p < 0,05. Results: The COVID-19 fear score (14.8 + 6.89) and the stress level (13.95 + 6.1) were higher in the out of follow-up outpatients compared to on-time outpatients. While the hospital service quality scores were quite right in all study groups and were not significantly different in the two groups (mean 21.70 + 2.08). The results showed that the lost follow-up outpatients were associated with COVID-19 fear scores (p = 0.001) and stress levels (p = 0.001), and were not related to hospital quality service levels. Conclusion: The level of stress and fear of COVID 19 decrease hospital visits at UNS Hospital.
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Background: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Ground glass opacity, fibrous stripe, and thickening of adjacent pleura are frequently reported sequelae of COVID-19. COVID-19 causing severe bronchiectasis in a previously healthy individual with no underlying lung conditions, has not been reported in literature yet. Therefore, this case report aimed to highlight the importance of COVID-19 infection-causing unusual lung changes such as bronchiectasis. Case report: This case, a 44-year-old woman, came to the UNS hospital complaining of shortness of breath, fever, and cough. The patient had no previous history of lung disease. The results of chest Xray when he entered the ER showed bilateral pneumonia. After further examinations, the COVID-19 nasopharyngeal RT-PCR swab was confirmed and was obtained with comorbid chronic heart failure. During the treatment, the sputum culture was examined, and Pseudomonas aeruginosa was found. Two weeks after being declared cured of COVID-19, a chest X-ray and chest CT scan were performed, and bronchiectasis was obtained. Discussion: The long-term sequelae of COVID-19 infection is still being studied. Bronchiectasis is one of the scars of COVID-19 infection which can appear rapidly during COVID-19 infection. The predisposition for a sequela to COVID-19 in the form of bronchiectasis still requires further research, possibly due to the severe manifestations of COVID-19 infection. Comorbid and the development of bacterial pneumonia as the secondary infection was still suspected as predisposing factors for bronchiectasis in this case. Conclusion: Bronchiectasis is an atypical sequela of COVID-19, which gives a poor prognosis in post-COVID-19 patients because it reduces the patient's quality of life.
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COVID-19 increases vulnerability for populations living in regions significantly impacted by the adverse effects of climate change. There is currently no definitive treatment for COVID-19. Colchicine is a drug that can reduce the severity of COVID-19 by inhibiting the NLRP3 inflammasome. This study aims to determine the effect of colchicine administration on the high-sensitivity C-reactive protein (HsCRP) and Neutrophil to Lymphocyte Ratio (NLR) levels in COVID-19 patients. This study was conducted at the UNS Hospital in February-March 2021. The inclusion criteria were moderate-grade COVID-19 patients. HsCRP and NLR examinations were carried out before and after giving the treatment. The treatment group received 2x0.5 mg colchicine for 7 days and standard therapy, while the control group received placebo and standard therapy. Statistical test using paired t-test and independent t-test. P is significant if p is less than 0.05. The study subjects were 40 patients, with 20 patients in the control group and 20 in the treatment group. There was a decrease in NLR and HsCRP levels in the treatment group before therapy (NLR = 7.89 + 3.45;HsCRP = 5.41 + 3.24 mg/dL) compared to after therapy (NLR = 3.59 + 2.25;HsCRP = 1.41 + 1.13 mg/dL) with p = 0.001. Colchicine reduces the degree of NLR and HsCRP in COVID-19 patients.